Coping with Cancer's Financial Side Effects
A cancer diagnosis is sometimes preceded by suspicion, and often symptoms. But it is always accompanied by shock. The phrase that turns over almost universally in the mind at the time of a cancer diagnosis is: "Life can turn on a dime."
But after the shock of the diagnosis, the aftershocks appear-some in rapid succession, such as telling the children, telling other family members and friends, notifying an employer. Others occur more gradually, subtle worries at first and then becoming major fears. Often these are financial in nature, and they can be almost as overwhelming as the cancer itself. Paraphrasing the above metaphor, "Life can hinge on a dime," as well.
As a higher percentage of the family's income is siphoned away by healthcare costs, virtually every other aspect of their quality of life can be affected.
A study published in the Annals of Internal Medicine found that 28 percent of those patients with the highest medical needs spent at least 10 percent of their household income on healthcare. More than 16 percent of "high-need patients" reported that they or a family member had to take out a loan or mortgage, spend savings, or take an additional job to finance the illness.
Lead author Dr. Ezekiel Emanuel of the National Institutes of Health wrote that just the last year alone of a terminal illness could cost a family more than $30,000 above any medical insurance coverage they may have. One consequent side effect, he noted, is an increased incidence of depression in caregivers and suicidal thoughts in the patients.
According to another study, almost half of the more than 1 million U.S. bankruptcy filings within the past year were due at least in part to major medical bills or other financial consequences of illness or injury.
Surprisingly, a lack of medical insurance was not a factor in these filings. Rather, wrote study author Elizabeth Warren of the Harvard Law School, "under-insurance" was the culprit. Families simply did not have enough medical insurance to cover catastrophic medical costs, or their coverage didn't have provisions to offset other financial implications of the illness, such as lost income.
Warren and her colleagues, Teresa Sullivan of the University of Texas and lawyer Melissa Jacoby, surveyed bankruptcy filers in eight judicial circuits around the country, accounting for about 18 percent of all filers. They noted that their findings illustrate just how fragile middle-class status is for many American families who are "just one serious illness away from financial collapse."
Other studies have backed up their findings. "In the overwhelming majority of cases, the person filing for bankruptcy experienced some economic catastrophe within the 12 to 24 months prior," concurred William Binzel of MasterCard International, as quoted in The Washington Post.
Without question, the emotional and physical tolls that cancer takes on a family are immeasurable. And any financial hardships endured certainly pale in comparison. But the financial challenges that may be faced are not negligible, and they may make an almost intolerable life challenge all the more difficult.
One often-overlooked suggestion for coping with the financial impact of cancer-find a good financial planner. Such services are not only for the rich!
A good financial planner can craft a solid, workable financial strategy that will prioritize expenses, coordinate payment plans, and recommend using assets in the most fiscally sound manner.
You may also want to consider a program offered by The American Cancer Society called "Taking Charge of Money Matters," which includes workshops on many of the financial issues facing families with cancer.
SOURCES:
The Washington Post, April 25, 2000
Annals of Internal Medicine, March 2000; 132:451-459
American Journal of Public Health, June 2000; 90:924-992
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